On July 19, seven pitches into a non-save situation, Red Sox reliever Koji
Uehara left a game against the San Francisco Giants clutching his right arm
and grimacing. It’s easy to imagine Red Sox fans grimacing too. After all,
the team has seen its fair share of bullpen injuries this summer —
including trips to the DL by closer Craig Kimbrel and reliever Junichi
Tazawa. But even after an MRI revealed that Uehara had suffered a right
pectoral strain, Kevin Samaha, PA-C, Physician Assistant in the Division of
Sports Medicine and Shoulder Surgery at Beth Israel Deaconess Medical
Center, suggests there’s reason for hope.

“A large majority of muscle strains can be managed non-operatively and will
go on to heal with very little lasting effects,” says Samaha. “Of course,
muscle strains need to be assessed on a case-by-case basis, and it’s
important for each individual to take enough time to heal properly.”

Your pectoral muscles help with movements of the arm and shoulder. They’re
what help you rotate the arm, pick up objects, and throw a baseball. So
it’s never good when a pitcher has a pectoral injury. But even with all the
strength and conditioning that goes into preparing for a major league
season, muscle strains can still happen.

“It’s a common misconception that strength alone can prevent muscle
strains,” says Samaha. “Muscle tissue will start to tear when it cannot
tolerate a stretch in the process of contracting. Therefore, muscle
flexibility is just as important as, if not more important than, strength
alone. When it comes to muscles, remember this: longer is stronger.”

Samaha explains that pectoral strains are categorized as grades one through
three. Grade 1 is the tearing of a small amount of muscle fibers, resulting
in some pain but allowing full function. Grade 2 is the tearing of a
significant amount of muscle fibers, resulting in moderate loss of
function. Grade 3 is when all muscle fibers are ruptured, resulting in
major loss of function. Symptoms of a torn pectoral muscle can include a
sharp pain near your shoulder, soreness, a burning sensation, and swelling
of the shoulder and arm.

“Depending on the grade, muscle strains can generally take somewhere
between four and six weeks to heal. Athletes, both professional and
recreational, should only resume physical activities once they’ve achieved
full strength, full range of motion and have no pain. Doing too much too
soon can lead to a higher risk of re-injury.”

So how can you help lower that risk of re-injury? Samaha notes that the
R.I.C.E. method of treatment — rest, ice, compression, elevation — can be
helpful for grades one and two strains. A sports massage is another option
to help with healing and recovery. And it’s also important to remember that
resting a torn muscle decreases its flexibility, which means athletes need
to stretch their pectorals to restore range of motion before participating
in strenuous activity again.

But as for Koji? Patience is key to a successful return to the Red Sox
bullpen. The Fenway faithful will just have to be patient, too.